KMPDU demands talks over Duale's plan to restrict private practice

Doctors’ union KMPDU has expressed concerns over Health Cabinet Secretary Aden Duale’s proposed plan to restrict doctors from pre-authorising insurance claims during official working hours, warning that the policy could prompt industrial and legal action.

The measure, according to the government, is intended to reduce conflicts of interest, prevent diversion of public service time into private practice, and manage rising insurance costs.

The union’s response follows remarks by CS Duale on Tuesday, in which he criticised some doctors for juggling multiple jobs and allegedly referring patients from public hospitals to private clinics.

Speaking in Tharaka Nithi County during the commissioning of a new ICU and amenity wing at Chuka Level 5 Hospital, Duale highlighted what he described as inefficiencies in certain public facilities, including Kenyatta National Hospital.

The CS said the government plans to use digital monitoring tools, including the Afya Yangu app, to track services and ensure claims are properly verified.

In a statement released on Wednesday, KMPDU said it will seek urgent engagement with the Ministry of Health, the Social Health Authority (SHA), and the Directorate of Health Assurance (DHA) to formally present its position on the proposed policy.

The union requested the suspension of any unilateral implementation of time-based restrictions pending meaningful consultations and indicated it may take “appropriate industrial, legal, or advocacy action” should the policy be enforced in a way that undermines service delivery or violates labour rights.

“The proposed mechanism has not undergone formal consultation with organised labour or other major stakeholders in the health sector,” the union said.

KMPDU described the plan, which would allow insurance claim pre-authorisations only outside official duty hours of 8 a.m. to 5 p.m., as “operationally unrealistic” and “administratively arbitrary.”

The union noted that the policy does not take into account the realities of Kenya’s public health system, including high doctor-patient ratios, extended working hours, emergency duties, and blurred distinctions between on-duty and off-duty times.

The union defended dual practice as a coping strategy amid insufficient staffing, delayed remuneration, high workload intensity, and limited incentives for exclusive public service.

“Time-based administrative controls do not effectively reflect the operational realities of public hospitals and risk arbitrary, disproportionate, and inequitable enforcement,” KMPDU stated.

While recognising the government’s concerns over accountability, conflicts of interest, and prudent management of public and insurance resources, the union emphasised that any policy affecting doctors’ terms, conditions, or scope of practice must respect constitutional guarantees of fair labour practices, align with existing collective bargaining agreements, and be developed through consultations with health sector unions.

KMPDU proposed alternative reforms, including structured dual-practice frameworks, roster-based or facility-verified authorisation mechanisms, incentives for exclusive public service, and accelerated recruitment and workload rationalisation within public hospitals.

“KMPDU remains committed to strengthening public healthcare delivery and protecting patient welfare,” the statement concluded.

The union’s National Executive Committee statement was signed by National Chairman Dr Abdi Mwachi, Secretary General Dr Davji Atellah, and National Treasurer Dr Mercy Nabwire, signalling a unified position in ongoing discussions with government authorities.